自拟内异消方联合亮丙瑞林治疗子宫内膜异位症的有效性和安全性

Efficiency and safety of Neiyixiao combined with leuprorelin in patients with endometriosis

目的：探讨自拟内异消方联合亮丙瑞林治疗子宫内膜异位症（EMs）的有效性和安全性。方法将82例EMs患者按随机数字表法分为2组各41例，治疗组采用自拟内异消方联合亮丙瑞林治疗，对照组单用亮丙瑞林治疗。血清CA125和RANTES采用酶联免疫吸附法检测。评价治疗前后盆腔症状和体征评分。结果治疗结束后3个月，治疗组盆腔症状评分[（0.4±0.2）分比（0.6±0.3）分；t＝3.552，P＝0.001]和体征评分[（0.8±0.4）分比（1.1±0.6）分；t＝2.664，P＝0.009]显著低于对照组；血清 CA125[（26.4±11.9）U/ml 比（33.9±12.8）U/ml；t＝2.012，P＝0.048]、RANTES[（34.3±14.1）ng/L 比（43.7±16.8）ng/L；t＝2.744，P＝0.008]显著低于对照组。治疗组总有效率显著高于对照组（90.2%比73.2%；χ2＝3.998，P＝0.046），不良反应发生率显著低于对照组（7.3%比24.4%；χ2＝4.479，P＝0.034）。随访12个月，治疗组复发率低于对照组（16.2%比46.7%；χ2＝5.954，P＝0.015）。结论自拟内异消方联合亮丙瑞林能降低 EMs患者血清CA125和RANTES水平，减轻症状和体征，其疗效和安全性优于单用亮丙瑞林。

Objective To investigate the efficiency and safety of self-made Neiyixiao decoction combined with leuprorelin in patients with endometriosis （EMs）. Methods A total of 82 patients with EMs were randomly recruited into a treatment group and a control group, with 41 patients in each group. The treatment group was treated with self-made Neiyixiao decoction combined with leuprorelin, and the control group was treated with leuprorelin only. The serum levels of CA125 and RANTES were detected with enzyme-linked immunosorbent assay. The symptoms and signs scores for pelvic endometriosis were evaluated before and after the treatment. Results The symptoms scores （0.4 ± 0.2 vs. 0.6 ± 0.3;t=3.552, P=0.001） and the signs scores （0.8 ± 0.4 vs. 1.1 ± 0.6;t=2.664, P=0.009） for pelvic endometriosis after the treatment in the treatment group were significantly lower than those in the control group. The serum levels of CA125 （26.4 ± 11.9 U/ml vs. 33.9 ± 12.8 U/ml; t=2.012, P=0.048） and RANTES （34.3 ± 14.1 ng/L vs. 43.7 ± 16.8 ng/L;t=2.744, P=0.008） after the treatment in the treatment group were significantly lower than those in the control group. The total effective rate in the treatment group was significantly higher than that in the control group （90.2%vs. 73.2%;χ2=3.998, P=0.046）, and the rate of adverse reaction significantly lower （7.3%vs. 24.4%;χ2=4.479, P=0.034）. The recurrence rate in the treatment group was significantly lower than that in the control group （16.2%vs. 46.7%;χ2=5.954, P=0.015） during 12 months of follow-up. Conclusion Self-made Neiyixiao decoction combined with leuprorelin can decrease serum levels of CA125 and RANTES, alleviate symptoms and signs, and its efficiency and safety are superior to leuprorelin alone in patients with endometriosis.